Calcium and Osteoporosis – Is Dairy Really Good For Your Bones?

Woman Drinking Milk With a StrawDairy products are the best sources of calcium in the diet and calcium is the main mineral in bones.

For this reason, the health authorities recommend that we consume three glasses of milk per day.

However, the situation appears to be a bit more complicated… the countries that consume the most dairy also have the most osteoporosis.

Dairy Doesn’t Make Sense From an Evolutionary Perspective

The idea that humans “need” dairy doesn’t make much sense to me, because we didn’t consume dairy throughout evolution.

Human beings are the only animal that consumes dairy after weaning. We are also the only animal that consumes dairy from another species than our own.

For these reasons, consuming dairy may be considered “unnatural” and something that is relatively new to our species. We’ve been evolving for millions of years, only consuming dairy for about 10.000 years (sources don’t agree on the exact number).

Then we have data showing that bone health was excellent in hunter-gatherers. They did not eat any dairy after weaning, but they did get significant amounts of calcium from other sources (1).

So… it doesn’t really make sense from an evolutionary perspective that humans would need dairy to optimize bone health.

However, even though it isn’t needed, that does NOT mean that it can’t be beneficial.

Bottom Line: Humans have been eating dairy for a relatively short time on an evolutionary scale. They are also the only species that consumes dairy after weaning, or dairy from another species than their own.

A Very Quick Primer on Osteoporosis

Smiling Elderly Woman

Osteoporosis is a progressive disease in which bones deteriorate, losing mass and minerals over time.

The name is very descriptive for the nature of the disease.

Osteoporosis = porous bones.

It has many different causes and factors completely unrelated to nutrition can be very important, such as exercise and hormones.

Osteoporosis is much more common in women, especially after menopause. Having osteoporosis significantly increases the risk of bone fractures, which can have a dramatic negative effect on quality of life.

Why Calcium is Important

Your bones serve a structural role, but they can also be considered as “reservoirs” for calcium, which has many other functions in the body.

The body maintains blood levels of calcium within a narrow range. If you’re not getting calcium from the diet, then the body pulls calcium from the bones in order to sustain other functions more important for immediate survival.

Some amount of calcium is continually excreted in the urine. If your dietary intake doesn’t compensate for what is lost from your body, then over time your bones will lose calcium, making the bones less dense and more likely to break.

Bottom Line: Osteoporosis is a common disease in Western countries, especially in postmenopausal women. It is a leading cause of fractures in the elderly.

The Myth About Protein and Bone Health

Cheese And Grapes

Some people believe that despite all the calcium, dairy can cause osteoporosis because it is high in protein.

The reasoning is that when protein is digested, it increases the acidity of the blood. Then the body pulls calcium from the blood in order to neutralize the acid.

This is the theoretical basis for the acid-alkaline diet, which is supposedly based on choosing foods that have a net alkaline effect and avoiding foods that are “acid forming.”

However, there really isn’t much scientific support for this theory.

If anything, the high protein content of dairy is a good thing. Studies consistently show that eating more protein leads to improved bone health (2, 3, 4).

Not only is dairy rich in protein and calcium, it is also loaded with phosphorus. Full-fat dairy from grass-fed cows also contains large amounts of Vitamin K2.

Protein, Phosphorus and K2 are all very important for bone health (5, 6, 7).

Bottom Line: Not only is dairy rich in calcium, it also contains large amounts of protein, phosphorus and Vitamin K2, all of which are important for optimal bone health.

Studies Where Dairy Has Negative Effects

Pouring Milk Into a Glass

There are some observational studies showing that increased dairy is associated with negligible or harmful effects on bone health (8, 9).

These studies are often cited by vegans and other people who are against dairy for some reason, but they carefully ignore all the other studies where dairy has positive effects (10, 11, 12).

The truth is that observational studies often give a mixed bag of results and they can’t be used to prove anything.

That being said, there are many more observational studies showing beneficial effects than there are showing no effect.

Luckily for us, we also do have plenty of real scientific experiments (randomized controlled trials) that can give us a clear answer of the effects that dairy products can have on our bones.

Bottom Line: There are some observational studies showing that dairy has no effect or a detrimental effect on bone health. However, there are even more observational studies showing beneficial effects.

“Real” Science Disagrees – Dairy Works

Dairy Products

The only way to determine cause and effect in nutrition is to conduct a randomized controlled trial.

This type of study is the “gold standard” of science.

It involves separating people into different groups. One group receives an intervention (in this case, eats more dairy) while the other group does nothing and continues to eat normally.

Many such studies have examined the effects of dairy and calcium on bone health. Most of them lead to the same conclusion… dairy works.

  • Childhood: During childhood, dairy and calcium lead to increased bone growth (13, 14, 15).
  • Adulthood: In adults, increased dairy decreases the rate of bone loss and leads to improved bone density (16, 17, 18).
  • Elderly: In the elderly, dairy improves bone density and lowers the risk of fractures (19, 20, 21).

Dairy has consistently led to improved bone health in multiple randomized controlled trials, in every age group. That’s what counts, period.

However, I must warn against the use of calcium supplements. Some studies show that they can increase the risk of heart attacks (22, 23).

It is best to get your calcium from dairy or other foods that contain calcium, such as leafy greens and fish.

Bottom Line: Multiple randomized controlled trials show that dairy products lead to improved bone health in every age group.

Dairy Isn’t “Needed” For Bone Health, But it Does Have a Benefit

Girl Drinking a Glass of Milk

If you’ve been following my blog for a while, then you will know that I am NOT a fan of the conventional nutritional wisdom.

The mainstream has an excellent track record of getting things wrong… such as when they demonized saturated fat and eggs, while telling us to eat more vegetable oils.

However, they appear to be right about dairy, which IS good for bone health, at least in the context of a Western diet.

There are so many studies to support it that it is pretty much scientifically proven.

However, even though dairy has beneficial effects, I do not think that it is “needed” because it doesn’t make evolutionary sense. It is very possible to maintain optimal bone health without dairy.

Bone health is complex and there are many lifestyle-related factors at play.

These include doing resistance exercise, getting adequate protein, Vitamin D and magnesium, as well as eating other calcium rich foods besides dairy.

46 Comments

  1. But if that’s true, and it must be, how come that where people eat more dairy there is more osteoporosis?

    • There is some other aspect of the western lifestyle that is causing osteoporosis. If we didn’t consume dairy, then we’d probably have even more osteoporosis.

      • I agree that evolutionarily, we did not consume dairy, and that we don’t need it now. Certainly, in terms of calcium, good bone broths, fish (especially small ones like sardines, anchovies with the bones included), pre-soaked nuts & seeds and leafy greens are a great place to start!

        And yes, bone health is a whole ecology, not just a calcium concern.

        But good quality RAW dairy can be a very nutrient-dense and healing food on many fronts. Look for top quality raw, high-fat cheeses, raw cream, raw whole milk and fermented milk products where possible. It’s the pasteurization and homogenization that causes problems for so many people.

        http://www.realmilk.com/

        Thanks for your great work!

        • I’d love to find raw dairy products. But I’m not sure if they’re legally allowed to be sold here in Australia.

          • You can buy unhomogenized milk but not unpasteurized in Australia. I’m lucky to have had a cow and I loved the raw milk. There was a product called Cleopatra’s bath milk, they got around the law by selling raw milk as a cosmetic product, you could Google them to see if it is still around.

      • I think it’s the lack of vitamin D that’s the problem. We’re afraid of the sun. Vitamin D is essential for strong bones.

      • There’s dairy and there’s dairy: low-fat dairy can contain only a fraction of K2 of its full-fat version (K2 is fat soluble).

        For instance Edam, which is one of the best sources of this vitamin, contains only 1/40th part of K2 as low-fat version. One cause of increased osteoporosis can be too much calcium without K2 “the homing device”, that directs calcium where it should go – the bones instead of arteries.

        Calcium in the form of dairy is not necessary. It shows up in East-Asian people, who have almost no osteoporosis even though their diet consists of rice and other non-dairy articles. Another explaining factor for the excess prevalence of osteoporosis in western nations might be too high consumption of wheat and other carbohydrates.

      • Regarding “other factors causing osteoporosis”, have you looked into DCAD (dietary cation-anion difference)? We (as vets) use the effect of DCAD to increase calcium mobilization from the skeletal pool over the last trimester of pregnancy to prevent hypocalcemia at the onset of lactation.

        I have long wondered if anyone has looked into this as a component cause of osteoporosis, particularly in regards to the Cl- anion, which is the only blood anion not regulated by the body, and is consumed alongside our beloved sodium in quantity. Food for thought.

      • For 69 years I consumed a quart of milk and a quart of yogurt every day, ate huge vegetable salads, low to no salt, wheat, and meat. I exercised, supplemented with calcium, magnesium, vitamin D.

        If dairy built strong bones, I would never have contracted Osteoporosis. But, I’ve learned that we received propaganda from the meat and dairy industry.

        When I fractured my lumbar spine in 2012, I changed my diet to reduce pain and inflammation, and began to eat healthy vegan. No salt or processed foods. Lots of dark leafy greens, beans, nuts and seeds, and a rainbow of colored vegetables and fruits. My exercises changed. And, I healed my spine.

        Then, a bad fall, one rainy day in 2013, my pelvis was fractured. But, this time, by avoiding dairy (and meat), and eating a healthy vegan diet, I grew new bone in record time. A month and a half from the initial injury, my pelvis was half healed. My physician said he had never seen anyone grow bone as fast as I. By my next checkup, 6 weeks later my physician found me totally healed. He found this totally amazing!

        I’ve learned that with severe osteoporosis, healing bones in record time with the right healthy foods does not stop the disease. I fractured my lumbar spine again in 2014 while still in physical therapy for my pelvis. I was getting stronger and doing so well. And now, I’m starting over again with another severe fracture,

        Because I don’t eat processed foods, or meat, sodium has never been part of my diet. I also don’t smoke, rarely drink alcohol, most of the parameters for Osteoporosis don’t apply to me. But, I have it just the same. Now, I research what I eat finding what nutrients my body needs and consuming those foods. Now, food – organic food is my medicine. Chemical herbicides are mineral chelators that bind minerals in the soil and not let them get into the plants that animals/people need to grow healthy bones, herbicides hinder plants from creating vitamins. Perhaps, that’s why foods grown with the organic method have greater nutritional value than food crops grown with chemicals. The organic method does not use herbicides to control weeds. We mulch, dig or pull weeds out..
        I think that’s why my bones heal faster.

        However, in 2014, I re-fractured my lumbar spine simply picking up a litter box. Did not bend enough at the knees or keep my back straight enough.

      • I consumed lots of dairy –THE EQUIVALENT OF TWO QUARTS OF MILK A DAY. And if dairy prevented osteoporosis, it missed me and my family!

        Perhaps, it was the exercise I took all my life. Yes, I hiked and walked during my younger years, but my main exercise was swimming laps. Swimming is great exercise but it does not build strong bones. It is not weight bearing. Perhaps, I should have spent part of the time in the weight room pumping iron.

        I looked at all the parameters and the only thing I could think of that may have contributed to my osteoporosis, was corticosteroid injections given to me by several doctors whenever an injury led to inflammation. Corticosteroids have now been linked to osteoporosis at the National Library of Medicine.

        Now I eat to reduce pain and inflammation in my body following Dr. Neal Barnard’s book, Foods that Fight Pain, and spice up my food and beverage with turmeric and other herbs that reduce pain and inflammation. No more drugs for me. Food is my medicine.

        Sodium has never been part of my life because I don’t eat processed foods and don’t add lots of salt to foods I cook. I use turmeric and other herbs instead.

        When I was pregnant long ago, I avoided processed foods and the salt shaker, but did eat meat and dairy. While nursing, I went to Weight Watcher’s but avoided food ingredients that may harm the baby, instead drank lots of water. Food was my medicine, I was just brainwashed about which foods to eat during those years.

        The NIH paper on calcium promotes kale as a good source of calcium. But kale does not have that much calcium as compared with collard greens.
        Collards have 266 mg calcium per serving, as well as 836 mcg of Vitamin K, and other nutrients..
        http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2411/2
        Kale has a mere 90.5 mg of calcium per serving with 22.8 mg Magnesium. http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2461/2

        I now supplement with 1,000 IU of vitamin D for each of two meals every day. But, when I was in my 40-50′s, the establishment would not let vitamin makers put more than 400 IU vitamin D into supplements. That also may have contributed to osteoporosis.

        Most Americans do not spend as much time in the sun due to concerns of skin cancer, or the use of sun screen. Therefore, we are not able to make our vitamin D from the sunshine and we need more supplementation. The AMA is still behind in the amount of vitamin D Americans need.

    • It could be, but still it’s weird that that concurring cause seems to exist only where people do dairies the most, whereas the SAD is widespread. Maybe there is much more to discover about calcium and osteoporosis? I mean maybe dairies do give calcium to the body, but nevertheless something else happens? Just my 2 cents, of course.

      • @ Tiziano maybe the typical SAD diet is so freakin’ terrible it inhibits the absorption of the calcium? All the phytic acid in their wheat/oats etc. Plus I think vitamin D is also an issue.

        Interesting though. I personally avoid dairy except for the occasional treat (I don’t trust it due to the pasteurization and homogenization, even though I know pasteurization is necessary when you don’t know the health of the cow) but I make sure I eat a lot of green veg and homemade bone broths instead.

        • Tiziano Solignani says:

          It could be, vit. D especially. I don’t eat dairy either, if I would I would look for unpasteurized and quality ones, but I have no clue whether you can find or not, I was told in many countries you cannot sell unpasteurized ones, so…

      • Have just discovered for myself why my endocrinologist was right – his apparent contradiction, that I had TOO MUCH calcium and THAT is why I should avoid calcium in order to avoid osteoporosis! Yes, and the reason?

        I have a parathyroid tumour (very common, but people don’t know they have one or more – until removed, they produce way too much calcium, which is leached out of the bones into the blood).

        Also, studies show that osteoporosis is quite prevalent in countries where a lot of dairy in consumed – and in countries where little calcium is consumed, there is very little osteoporosis. Check out the websites for yourself.

      • Emmanuel says:

        I was reading an article a while ago. Cannot remember the source, but I think, long story short it was saying that the huge amount of calcium intake of a person who eats lots of dairy product actually is bad for the bones. This is not the original website where I found it, however I think the study quoted is the same. http://www.greenmedinfo.com/blog/how-too-much-calcium-can-break-your-bones

        It’s a hypothesis, at least.

    • Could it be due to the pasteurization process, so ubiquitous in Western countries? Raw dairy has been consumed by most traditional societies and they never had osteoporosis.

  2. Yes, and we’re also the only species to fly around in planes and play golf on the moon. The point should be; “look how dairy has enabled the human species to thrive!”

    Consumption of dairy predates the dawn of agriculture by thousands of years. It makes sense too because during hunting expeditions people would often capture and keep the young animals as pets or to eat later when bigger.

    Certain animals like horses, yaks, water buffalo and sheep were quite easy to domesticate which enabled us to migrate far distances. In fact, the pilgrims at Jamestown were struggling to establish a foothold in America until they were able to establish a herd of cows and goats and then they thrived.

    Like Kris said, there are other aspects of our SAD diet which is causing this because the prevalence of osteoporosis was rare in the past. I think it has to do with the fact that we’ve replaced our saturated fat with vegetable seed oils, carbs and sugars. Instead of using pastured lard (second highest source of vitamin D) for cooking we use rancid, vitamin-less garbage!

    • Yes it has been proven that calcium increases bone density and this is undisputed but as I have now discovered through my research, the results are not long lasting and, that those having had prolonged very high calcium intake in earlier years are more likely to have osteoporosis later in life.

  3. I have heard that drinking soda pop is the worst thing for osteoporosis. Apparently it sucks the calcium right out of your bones. Is that true?

  4. The idea that humans didn’t consume any milk products until the “dawn of agriculture” is promulgated with weak evidence.

    It would have been easy for early humans to have hobbled cows, buffalo, or any other ungulate to be able to obtain their milk.

    When any animal is killed by a predator, that animal’s milk is consumed during the feast.

    So to say humans are the “only” species to consume the milk of another species is just plain wrong.

    Pass the butter, please.

    • Ants milk aphids to obtain their nectar.

    • Tiziano Solignani says:

      I am sorry, I do not understand “hobbled” but if that means to milk, I do not think you can easily do a wild beast.

      As for “any” animal, it has to be a female and in the after birth time-frame and, event in that frame, how would they have drunk the milk?

    • I agree with Tiziano. This concept that we’d run up and milk “hobbled” animals is a little out there. It *might* work for domesticated animals… but an injured, wild Mama? All I can say is… you get to do the milking first. I’ll jump in if you’re not mauled or bitten in the whole process.

      And yes, I’m sure any milk in a killed female would be consumed as side not to the main feast. That’s not the same as depending on it as a regular food source.

  5. Cecily Porter says:

    Wish you had differentiated between pasteurized and raw milk. Pasteurized is dead (duh!) and not beneficial, raw has so many enzymes, it almost digests itself and is very beneficial to health. My source on this is Dr Natasha Campbell-McBride, GAPS Diet.

  6. The observational correlation that countries with high intake of dairy also have the highest rates of osteoporosis is easily explained by vitamin D, that is probably the single most important factor for bone health.

    It’s here up in Scandinavia were we consume most dairy. Those who didn’t tolerate the lactose in dairy didn’t survive in this cold climate. That has resulted in populations with the lowest incidence of lactose intolerance in the World… together with the North African Tuaregs living in the Sahara desert, equally dependent on milk (from camels) for their survival.

    The long dark winter in Scandinavia (together with health authorities recommending us to avoid the sun because of the skin cancer risk) results in D-vitamin deficiency. We have a high rate of osteoporosis but to my knowledge the Tuaregs in sunny Sahara don’t.

    • Tiziano Solignani says:

      It makes sense. Now it could be interesting to compare rates of osteoporosis between people in your country eating dairy and the minority who does not.

  7. Caffeine: I love it, but my bones don’t.

  8. Jayden Anker says:

    Looking at your references to support milk consumption I notice that a lot are out dated, and you don’t have any meta-analysis to support the association between milk and osteoporosis. It would be great to see a review of more recent reviews, ones source dated back to 1985.

    In the meta-analysis of cohort studies, there was no overall association between milk intake and hip fracture in women but more data are needed in men
    http://onlinelibrary.wiley.com/doi/10.1002/jbmr.279/abstract

    Here is also a good article that is linked to recent research. http://www.vegsource.com/news/2010/12/new-study-increased-milk-intake-does-not-protect-against-osteoporosis-but-does-promote-ovarian-and-p.html

    I love my milk and want to keep drinking it, but too much of it seems to course harm so may not be a good option.

    Thanks for all your work so far a research reviews they are very helpful.

  9. Kris, unfortunately there are many wrong assumptions and wrong reasoning in your article. Milk is the only complete food on the planet. Without milk no mammal would exist. You cannot compare apples and pears to come to a conclusion. Of course the milk you buy in the supermarket is not fit for human consumption, and it will cause all the problems that so called scientist claim it will prevent.

    But milk has unbelievable health properties when consumed in raw form. For thousands of years milk was prescribed as medicine, even today the wise doctors still prescribe it. And pharmaceutical companies are working frantically to isolate components of milk in order to create synthetic particles for their medicinal concoctions.

    To say because humans didn’t consume milk in the beginning, therefore milk can’t be good is not a very good reasoning. The complete nutrition is in the milk irrespective if somebody is using it or not. It’s like saying bananas are no good because Eskimos never ate them. There are many reasons why the first man didn’t drink milk. One of them is… it wasn’t available. I don’t think it would be reasonable to expect the first man running after some vicious wild animal shouting, hey stop I want to milk you.

    About calcium and osteoporosis… the lack of calcium is not the problem… it is mainly the lack of magnesium in conjunction vitamin D and K. Magnesium controls the amount of calcium in the cells. The cells should be low in calcium and high in magnesium.

    When you have a shortage of magnesium you will have to much calcium in the cells. And it is not just the amount that matters, it’s the ratios. The cells become calcified, and that creates all sorts of problems (including diabetes + 1000 other diseases). So when the doctor prescribes calcium supplement that does much more damage than good. In most instances it will make osteoporosis and every other disease worse not better.

  10. Mary Marshall says:

    All of the research you cite is from the 80′s and 90′s.

    Couldn’t find anything more recent?

  11. Holly Arnold says:

    One thing that I have read in many places that I found interesting is that calcium seems to be more easily absorbed from plant sources like broccoli and spinach than from dairy sources. Supposedly, although dairy actually has more calcium, the problem is that not a lot of it is absorbed into the body.

    So you actually get more calcium from dark, leafy greens. Maybe you could shed some light about what you think in that regard…

    I stopped drinking cow’s milk a few years ago and have noticed a change my health for the better. Less colds, less stomach upsets and less bloating.

    I switched to unsweetened almond milk and that seems to be better for me with the added bonus of no sugar to deal with. I assume I probably have a lactose sensitivity. I still can eat cheeses and cream without any issues though.

  12. Even if it’s not true that consuming dairy increases acidity and therefore causes brittle bones, then what about link with dairy to cancer? It’s regarding the casein protein found in milk. Tests were done on mice and when they were given increased levels of this protein then tumour growth increased and when they were given less of this protein then tumour growth decreased.

    They kept increasing and decreasing the casein protein levels and every time the tumour growth increased with more protein and decreased with less protein. That’s pretty strong evidence. Also the majority of milk sold in supermarkets is from pregnant cows meaning they have a cocktail of 35 different hormones such as oestrogen and 11 growth factors which can make cells grow out of control and cause cancers.

    • There is no evidence that dairy is linked to cancer in humans. If I remember correctly, the rat studies you speak of (from The China Study?) used aflatoxin to induce cancer. Really doesn’t prove anything.

      • Aflatoxin was the carcinogen given to induce cancer, yes, but this was done to many groups of animals. Different groups were fed diets containing different percentages of the same protein (e.g. casein from dairy, plant proteins etc.) and other groups were given the same percentage of protein but differing types.

        In all cases the rate of growth of cancer cells was observed and consistently it was shown that increasing levels of animal protein promoted cancer cell growth but plant protein did not. The researchers were effectively able to turn cancer growth on and off just by controlling the amount of animal protein in the diet.

        So, in summary, aflatoxin induced the cancer to grow in the first place but animal protein in the diet seemed to provide the right conditions for it to grow.

        I would say that’s pretty strong evidence!

  13. Forget bone health for a second. Milk makes you a fat tub of lard if you drink it.

  14. It’s so interesting that even when you do a really great scientific review, people still contradict it based on personal experience and pseudoscience.

  15. I agree, magnesium and Vitamin D etc. If you are told like I was, that your Vitamin D levels are too low so you must supplement, have your thyroid levels checked out first in order to ascertain whether you have parathyroid disease.

  16. Thanks for a fascinating discussion on a very complex topic.

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